Drug interactions
Buprenorphine buccal + Clozapine
Severity: Major
Buprenorphine buccal and Clozapine: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs can prolong the QT interval, so using them together raises the chance of ventricular arrhythmias. Buprenorphine also adds CNS and respiratory depression to the sedation caused by clozapine.
What this interaction means in plain words
Buprenorphine buccal and Clozapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive effects on cardiac repolarisation, plus additive CNS depression.
What to do
Consider alternatives where possible. If the combination is needed, check a baseline ECG, correct electrolyte disturbances, and monitor for QT prolongation and sedation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Buprenorphine buccal and Clozapine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine Major
Frequently asked questions
Can I take Buprenorphine buccal with Clozapine?
MediHelp rates the interaction as major. Buprenorphine buccal and Clozapine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs can prolong the QT interval, so using them together raises the chance of ventricular arrhythmias. Buprenorphine also adds CNS and respiratory depression to the sedation caused by clozapine.
How serious is the interaction between Buprenorphine buccal and Clozapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider alternatives where possible. If the combination is needed, check a baseline ECG, correct electrolyte disturbances, and monitor for QT prolongation and sedation.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
